Talking to Children about Non-Suicidal Self-Injury and Suicidal Ideation

    ‘Suicide’ and ‘Self-Harm,’ words every parent never wants to hear associated with their child. Although these topics can be uncomfortable and unsettling, it is important that we are equipped to address them with our children if needed. This is especially poignant when noting the statistics for children and adolescents.

    Suicide and Non-Suicidal Self-Injury (NSSI)

    In 2020, there were 907 deaths by suicide in Hong Kong with those under 15 years of age representing 1% of the statistic. The proportion by age increases to 6.5% for those between 15 and 24 years of age. Research has also shown that 17% of all individuals will engage in non-suicidal self-injury in their lifetime, with the average onset of the first incident at 13 years of age. Given these statistics, it is crucial to feel well equipped to address these matters with our children.

    As parents, it is common to experience anger, confusion, upset, and fear upon learning about our child's self-harm behaviours or suicidal ideation. Understandably, these emotions can often come across in our communication when listening to our children. Despite intentions being positive, intent may not always reflect impact.

    Importance of Language

    One such example of this discrepancy is the choice of language. When it comes to suicidal ideation and self-harm, parents can rightly so panic. In amongst the panic, we default to talking our children out of their self-harm or suicidal ideation. This is often expressed by saying things such as “Think about how this affects us.” ,“We will be sad if you’re gone.” or “We love you so much, why would you do this?.”

    Whilst the intent is to remind our child of their importance within the family, it may indirectly invalidate their experience and inflict a sense of shame or guilt. If your child has suicidal ideation, it is highly likely that they have already considered the impact on those around them so reminders may create tension. Instead, try reminding them that their loved ones are there for support. The best way to provide support is through active listening and understanding. Of course, it can be difficult to see things from your child's perspective at the best of times and even more so during a crisis. This difficulty may come across in comments such as “You have so much to live for.,” “You have such a great life.,” “There are others who are in worse positions than you.” or “Look at the positives”. Whilst it can always be argued that someone in the world is in a worse position, this is not the issue. When contemplating suicide or self-harming, reasoning is not based on the lives of others but the experience of the self. It will always be hard to fully understand another’s perspective, so it is best not to force it. The good news is that just because we cannot understand does not mean we cannot support. Try not to focus on reasoning your child’s behaviour and instead focus on supporting them through this difficult period.

    Practical Tips

    Whether your child has come to you themselves or you have been informed by someone else, be sure to thank your child for opting to inform or share with you. It is a positive that they have shared, whether directly or indirectly. This is the most vulnerable your child will have been with you, and it is an opportunity to build a strong relationship. So, what is next?

    1. Listen

    Be sure to actively listen to your child when they share their experiences with suicidal ideation and self-harm. Clear out all distractions and be fully present. Your reactions and responses in this crucial moment mean a lot and will set the tone for future conversations. Do not forget to make use of both verbal and non-verbal cues to demonstrate you are fully committed in the conversation. There is also no pressure to rush through the conversation. As social beings, we can often be afraid of silence, but silence is important, it allows those involved to gather their thoughts.

    2. Validate and Support

    Encourage your child to share their thoughts and feelings around their suicidal ideation or self-harm. Try not compare your own experiences to theirs or become overwhelmed with finding ways to solve the ‘problem,’. If you are unsure what to say, try to reflect back what has been said to ensure your child knows you heard them. Discuss next steps for support such as professional help. Be sure to provide your child with opportunity for input- “Who would you like to see?”, “How can I help?” or “What areas do you need more support in?”

    If you are concerned for your child’s well-being, do not be afraid to ask about suicidal ideation or self-harm. Let your child know you are concerned for them and their well-being. Be sure to emphasise that they are not in trouble and that you will not get angry. Often children withhold information out of fear of being punished or upsetting others. When it comes to suicidal ideation it is important to be direct and clear. Try not to be afraid of the word ‘suicide.’ though it can be disconcerting to bring up. Many believe that by discussing suicide, you are directly planting the thought- this is untrue. Open communication is the first step in managing suicide risk as well as allowing your child space to share and feel heard. Just as importantly, do not be afraid to seek support for yourself too, after all, how can we support those around us if we ourselves are not supported?

     

    Reference

    1. Hong Kong Jockey Club. (2021, July 31). Centre for Suicide Research and Prevention. Retrieved January 26, 2022, from https://csrp.hku.hk/

    Topics: Mental Health

    Rachel Chan Mazariegos

    Rachel Chan Mazariegos

    Behavioural Therapist and Educational Psychometrician

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